Surgical forceps

ABSTRACT

This application presents a bifurcated, optimally-angled surgical forceps. In one example, this surgical forceps may enable a more natural maneuver for initial clamping of the vas deferens through the scrotal skin. This may be more comfortable for users and easier to maintain, and may provide greater tactile surface contact between the thumb and vas deferens. This device also may provide the surgeon with an entire segment of vas deferens upon which the vasectomy may be performed, thus reducing the need for frequent repositioning of instruments. The device may also be applied to other surgical procedures that may benefit from the features of the device and where a section of a tubular anatomical structure may need clamping at two points along its length. Examples include blood and lymphatic vessels, ducts of the digestive system, and large nerves or nerve bundles.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is based upon and claims priority to U.S. ProvisionalApplication Ser. No. 61/565,628, filed Dec. 1, 2011, attorney docket no.064693-0260, entitled “Vasectomy Forceps”, the entire content of whichis incorporated herein by reference.

BACKGROUND

1. Field

This application relates generally to medical instruments, particularlysurgical forceps for examinations and operations. This applicationfurther relates to vasectomy forceps. This application also relates toperforming a vasectomy.

2. General Background and State of the Art

Vasectomy is a male birth control surgical procedure that involvessevering the vas deferens and tying and/or sealing the ends, preventingthe entry of sperm into the seminal stream. The procedure is oftencarried out in a physician's office or clinic and is done under localanesthesia. The two widely used methods for performing a vasectomy are“traditional” and “no-scalpel.”

In the “traditional” method, the surgeon makes an incision on thescrotum to access and directly clamp the vas deferens. The surgeon thenoccludes a small piece of the vas deferens and seals the ends bysuturing, cauterizing or applying surgical clips, or employing acombination of sealing methods. The procedure is done for both vasdeferentia.

The “no-scalpel” method involves the surgeon accessing the vas deferensby puncturing the scrotum with a sharp hemostat, usually after clampingthe vas deferens through the scrotal skin. The surgeon first locates thevas deferens through the scrotum, typically by rolling the vas deferensbetween the thumb, index and middle fingers. Efficiency in locating thevas deferens by feel requires experience. Once the vas deferens has beenlocated and isolated from other structures through the scrotal skin, itis pushed toward the surface to enable clamping. In general practice,the surgeon uses one finger on the underside of the pinched scrotal skinto push the vas deferens between his two fingers on the opposing (upper)side. This forces a segment of the vas deferens to a position close tothe surface where it can be clamped.

The vas deferens is exposed from the puncture site using variousforceps. The surgeon then occludes the vas deferens and seals thesevered ends by suturing, cauterizing or applying surgical clips, oremploying a combination of sealing methods. The procedure is done forboth vas deferentia. No-scalpel vasectomy was disclosed in detail in adocument entitled “No-Scalpel Vasectomy. A Training Course for VasectomyProviders and Assistants” 2^(nd) Edition, published by EngenderHealth in2007. Entire content of this document is incorporated herein byreference.

Various types of vasectomy forceps used to clamp the vas deferens areavailable in the market. Most forceps used in vasectomies consist of anintersecting pair of scissoring arms with a ratcheting mechanism tomaintain the desired clamping pressure and tips shaped to grasp thetissue (in this case the vas deferens) in a certain way. For example,the distal end of the ring-type vasectomy forceps consists of a singlepair of half-hooks on opposing arms that come together to form a ring,between which the vas deferens is clamped. Often, several types offorceps are used in a single procedure. A plurality of forceps may beused simultaneously to clamp the exposed vas deferens at two locations,enabling the surgeon to occlude and seal the vas deferens between twoclamped points.

The following are a few types of commonly used vasectomy forcepsavailable in the market: ring-type (cantilevered or non-cantilevered);teardrop; ball-end (non-penetrating); hemostat (Mosquitoforceps—Halstrad or Kelly; curved or straight); and tissue forceps(Allis forceps or surgical tweezers).

Several problems with current tools and methods of no-scalpel vasectomyexist. For example, the wrist action currently required to push the vasdeferens to the surface of the scrotum feels unnatural, isuncomfortable, and is difficult to maintain. Furthermore, the use of theindex finger, middle finger, or tip of the thumb to push the vasdeferens between the other two fingers provides little tactile surfaceagainst the vas deferens, making isolation and positioning of the vasdeferens difficult.

Additionally, existing forceps require much maneuvering and transferringof the vas deferens between different forceps throughout the procedure,in order to occlude and seal the vas deferens on both sides of theclamp.

Furthermore, during surgery, the surgeon typically locates the vasdeferens from the exterior of the scrotum by rolling the vas deferensbetween the fingers and thumb. Once the vas deferens is located and thesegment is pushed outward towards the surgeon, the approach directionfor clamping the vas deferens is often from the side (along thepatient's abdomen) rather than from the top of the patient. The graspingand clamping of the vas deferens with a straight tool in this positiontypically make it cumbersome for the surgeon. Use of a straight toolwould further occlude the intended clamping site.

SUMMARY

This application presents surgical forceps that may be used to clamptubular anatomical structures at least at two points.

For example, this surgical forceps enables a more natural maneuver forinitial clamping of the vas deferens through the scrotal skin, as it isclamped on both sides of a downwardly pressed thumb (against pressurefrom the index and middle fingers on the opposing side of the pinchedscrotal skin). This maneuver resembles that commonly used in routinephysical examinations, which is more familiar to practitioners, is morecomfortable and easier to maintain given its more natural wristposition, and provides greater tactile surface contact between the thumband vas deferens. This device may therefore be especially beneficial forless experienced surgeons who perform vasectomies. The device mayadditionally provide a hemostatic function by compressing small bloodvessels at each end of a segment of vas deferens, thereby keeping thesurgical site clear of blood.

This surgical forceps also provides the surgeon with an entire segmentof vas deferens (not just a clamped loop) upon which the vasectomy maybe performed, thus reducing the need for frequent repositioning ofinstruments. Once the vas deferens is located, grasped and clamped,local anesthetic may then easily be injected at each end of the vasdeferens segment. The vasectomy forceps reduces the need to constantlyre-adjust the surgical site while providing a means to manipulate thesurgical site without losing grasp over the segment of vas deferens.

The surgical forceps may also be applied to other surgical proceduresthat may benefit from the features of the device and where a section ofa tube-type vessel or duct may need clamping at two points along itslength. Examples include blood and lymphatic vessels, ducts of thedigestive system, and large nerves or nerve bundles.

The surgical forceps has a proximal end and a distal end. The surgicalforceps may comprise a first elongated arm, a second elongated arm, ahinge, a first finger grip at the proximal end of the first elongatedarm, a second finger grip at the proximal end of the second elongatedarm, a ratcheting mechanism, a first jaw at a distal end of the firstelongated arm, and a second jaw at a distal end of the second elongatedarm. The first elongated arm and the second elongated arm may be pivotedat the hinge.

The ratcheting mechanism may comprise a first ratchet on the firstelongated arm adjacent to the first finger grip and a second ratchet onthe second elongated arm adjacent to the second finger grip. The firstratchet may engage with the second ratchet as the finger grips arebrought toward one another.

The first jaw may be bifurcated to form a first branch and a secondbranch. The first branch may further comprise a first tip at the distalend of the surgical forceps. The second branch may further comprise asecond tip at the distal end of the surgical forceps.

The second jaw may be bifurcated to form a third branch and a fourthbranch. The third branch may further comprise a third tip at the distalend of the surgical forceps. The fourth branch may further comprise afourth tip at the distal end of the surgical forceps. The first curvedenclosure and the second curved enclosure may be both circular. Thefirst curved enclosure and the second curved enclosure may have the samediameter. The same diameter may be at least 3 millimeters. The samediameter may vary in the range of 3 millimeters to 5 millimeters.

When the ratchets are engaged, the first tip and the third tip may forma first curved enclosure, and the second tip and the fourth tip may forma second curved enclosure.

When the ratchets are engaged; the first jaw and the second jaw may forma first plane. The first finger grip, the second finger grip, the firstelongated arm, and the second elongated arm may form a second plane. Inone embodiment, the first plane and the second plane may beperpendicular to each other. In another embodiment, the first plane andthe second plane may be at an oblique angle to each other.

The first elongated arm, the second elongated arm, the hinge, orcombinations thereof may be bent at an angle. In one embodiment, thefirst elongated arm and the second elongated arm may be both bent at anangle. In another embodiment, the hinge may be bent at an angle.

The surgical forceps may further comprise a stem located between thehinge and the distal end of the surgical forceps. The stem may have abroad base.

The distance between the two branches of the first jaw and the distancebetween the two branches of the second jaw may be equal. This equaldistance may be at least 10 millimeters. This equal distance may alsovary within the range of 10 millimeters to 30 millimeters.

The tips may be configured to apply at least one surgical clip.

This application further presents a method that may use surgical forcepsto perform a vasectomy. This method may comprise pinching the vasdeferens with fingers, clamping the vas deferens with the surgicalforceps at two locations, and occluding the vas deferens. In anotherembodiment, this method may comprise pinching the vas deferens withfingers, clamping the vas deferens with the surgical forceps at twolocations, separating the vas deferens from the surrounding tissue, andflipping the surgical forceps prior to occluding the vas deferens.

It is understood that other embodiments of the devices and methods willbecome readily apparent to those skilled in the art from the followingdetailed description, wherein only exemplary embodiments of the devices,methods and systems are shown and described by way of illustration. Aswill be realized, the devices and systems are capable of other anddifferent embodiments and their several details are capable ofmodification in various other respects, all without departing from thespirit and scope of the invention. Accordingly, the drawings anddetailed description are to be regarded as illustrative in nature andnot as restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

Aspects of the surgical forceps are illustrated by way of example, andnot by way of limitation, in the accompanying drawings, wherein:

FIG. 1 is an isometric view of an exemplary surgical forceps in a closedposition; and

FIG. 2 is a side view of the exemplary surgical forceps of FIG. 1 in aslightly open position.

FIG. 3 is an isometric view of the exemplary surgical forceps of FIG. 1in an open position.

DETAILED DESCRIPTION

The detailed description set forth below in connection with the appendeddrawings is intended as a description of exemplary embodiments and isnot intended to represent the only embodiments in which the retractorscan be practiced. The term “exemplary” used throughout this descriptionmeans “serving as an example, instance, or illustration,” and should notnecessarily be construed as preferred or advantageous over otherembodiments. The detailed description includes specific details for thepurpose of providing a thorough understanding of the retractors.However, it will be apparent to those skilled in the art that theforceps and may be practiced without these specific details.

This application presents surgical forceps that may be used to clamptubular anatomical structures at least at two points.

FIG. 1 depicts an isometric view of an exemplary surgical forceps 100 ina closed position, and FIG. 2 depicts a side view of the exemplarysurgical forceps 100 of FIG. 1 in a slightly open position. FIG. 3depicts a side view of the exemplary surgical forceps 100 of FIG. 1 inan open position. The surgical forceps may be constructed with a rigidmaterial such as metal or plastic. The forceps may be re-usable orsingle-use disposable.

A surgical forceps has a proximal end and a distal end and may comprisea first elongated arm 101 and a second elongated arm 102, a hinge 103, afirst finger grip 113 at the proximal end of the first elongated arm, asecond finger grip 112 at the proximal end of the second elongated arm,a ratcheting mechanism comprising a first ratchet 110 on the first armadjacent to the first finger grip and a second ratchet 111 on the secondarm adjacent to the second finger grip, a first jaw 104 at a distal endof the first elongated arm, and a second jaw 107 at a distal end of thesecond elongated arm. The first elongated arm 101 and the secondelongated arm 102 may be pivoted at the hinge 103. The first ratchet 110may engage with the second ratchet 111 as the finger grips are broughttoward one another. The first jaw may be bifurcated to form a firstbranch 131 and a second branch 132. The first branch 131 may furthercomprise a first tip 105 at the distal end of the surgical forceps. Thesecond branch 132 may further comprise a second tip 106. The second jaw107 may be bifurcated to form a third branch 133 and a fourth branch134. The third branch 133 may further comprise a third tip 108 at thedistal end of the surgical forceps. The fourth branch 134 may furthercomprise a fourth tip 109.

Each elongated arm 101 and 102 may be pivoted at the hinge 103 to createthe scissoring action. Finger grips 113 and 112 may allow a user toplace her fingers in and operate the forceps at one end while engagingthe jaws 104 and 107 for the clamping action at the other. The user mayuse the ratcheting mechanism to lock the forceps in the desiredposition. The finger grips 113 and 112 side of the forceps shall bereferred to as the proximal end while the jaw 104 and 107 side of theforceps shall be referred to as the distal end.

When the ratchets 110 and 111 are engaged; the first jaw 104 and thesecond jaw 107 may form a first plane; and the first finger grip 113together with the first elongated arm 101 and the second finger grip 112together with the second elongated arm 102 may form a second plane. Thefirst plane and the second plane may be at a perpendicular or an obliqueangle to each other.

The surgical forceps may further comprise stems 141 and 142 locatedbetween the hinge and the distal end of the surgical forceps. The stems141 and 142 may have a broad base to provide strength and stabilityagainst bending and misalignment of the jaws when the elongated arms arebrought together repetitively after many surgical procedures.

In one embodiment, the tips 105, 106, 108 and 109 may be flat. Inanother embodiment, the tips may individually be curved. The tip mayhave any curved shape. Examples of the curved shapes are circular,elliptical, oval, undulated, and teardrop shapes. Square, rectangularand triangular tips are also possible. Combinations of these shapes arealso possible.

In one embodiment, the first branch 131 may further comprise a first tip105 at the distal end of the surgical forceps 100. The second branch 132may further comprise a second tip 106. The third branch 133 may furthercomprise a third tip 108 at the distal end of the surgical forceps 100.The fourth branch 134 may further comprise a fourth tip 109. In oneembodiment, when the ratchets are engaged, the first tip opposes thethird tip, and the second tip opposes the fourth tip. The first tip andthe third tip may form a first enclosure, and the second tip and thefourth tip may form a second enclosure. The first enclosure and thesecond enclosure may be curved. The first enclosure and the secondenclosure may also be circular. The first circular enclosure and thesecond circular enclosure may have the same diameter. The diameter ofthese enclosures may be at least 3 millimeters for surgical operationsinvolving the vas deferens. The at least 3 millimeters diameters mayalso be suitable for surgical operations involving variety of tubularanatomic structures, for example, some larger diameter blood vessels,intestines, fallopian tubes, and bile duct. The diameter of thesecircular enclosures may vary in the range of 3 millimeters to 5millimeters. The circular enclosure diameters smaller than 3 millimetersare also possible, for example, for surgical operations involvingnerves, smaller diameter blood vessels, and nerve sheaths.

In an exemplary embodiment, at the distal end, the tips 105, 106, 108and 109 may come together when the user brings the elongated arms 101and 102 to a closed position. In another embodiment, the tips 105, 106,108 and 109 may form an enclosure in the closed position of the deviceas shown in FIG. 1. In yet another embodiment, the enclosures formed bythe tips 105, 106, 108 and 109 may clamp the vas deferens through thescrotal skin. The enclosures formed by the tips 105, 106, 108 and 109may also provide a hemostatic function by compressing small bloodvessels at each end of a segment of vas deferens, thereby keeping thesurgical site clear of blood. The diameter of the circular enclosuresmay be in the range of 3 millimeters to 5 millimeters to accommodate thevas deferens and thickness of the scrotal skin. In an exemplaryembodiment, the circular enclosure diameter may be about 4 millimeters.This about 4 millimeters circular enclosure diameter may provide adeeper grasping action to clamp around the vas deferens through thescrotum.

During the vasectomy, the thumb and located vas deferens segment may bepassed between the branches of each jaw and the vas deferens segment maythen be grasped by the tips and clamped in place. In one embodiment, thedistance between the two branches of the first jaw 104 and the distancebetween the two branches of the second jaw 107 may have equal distance.This equal distance may be at least 10 millimeters to accommodate thewidth of a human thumb tip for surgical operations involving the vasdeferens. The equal distance may vary in the range of 10 millimeters to30 millimeters to surgically operate on the vas deferens. For othertypes of surgical operations, the equal distance may suitable vary toaccommodate different lengths of anatomical structures.

In the exemplary embodiment of FIGS. 1-3, the surgical forceps 100 maybe angled to improve visibility and access to the scrotum and vasdeferens. The angled forceps may provide the surgeon with improvedvisualization and reduced time for grasping, while the ergonomic designof the forceps provides for comfortable application of the device ontothe scrotum. In one embodiment, the forceps may be flipped afterclamping the vas deferens to angle the tips upward to hoist the vasdeferens up from the surgical field, thereby providing the surgeon witha better presentation of the surgical site.

The surgical forceps may be bent at the first elongated arm 101, thesecond elongated arm 102, the hinge 103, or combinations thereof. Forexample, the surgical forceps may be bent at both the first elongatedarm and the second elongated arm to provide the angled forceps. Inanother example, the hinge may be bent to provide the angled forceps. Inyet another example, the first elongated arm, the second elongated arm,and the hinge are all bent to provide the angled forceps.

In an exemplary embodiment, the bending angle of the angled forceps mayvary in the range of 120 degrees to 160 degrees. In an exemplaryembodiment, the bending angle may be at about 155 degrees.

Once clamped, the device may remain in the clamped state until the vasdeferens is exposed and/or occluded. The locking mechanism may bereleased on completion of the surgical procedure.

Once the vas is brought into the open, it may be occluded using avariety of methods. Examples of these methods are cutting, ligation withsutures, division, cautery, application of clips, excision of a segmentof the vas, fascial interposition, and combination thereof. Ligation maybe preferred. For example, ligation with excision and fascialinterposition may be preferred.

In one embodiment, the tips 105, 106, 108 and 109 may serve as seats forsurgical clips used for closing the occluded ends of a tubularanatomical structure, for example the vas deferens, similar to acrimping tool.

In an alternate exemplary embodiment (not shown), the tips may beseparated by a gap while the forceps are in substantially fully closedposition. This gap may prevent the tips from puncturing the scrotum andscarring the skin. In the exemplary embodiment, the gap between theopposed tips may range from 0.5 millimeter to 2 millimeters toaccommodate the scrotum skin thickness while effectively clamping thevas deferens.

This application further presents a method that uses surgical forceps toperform a vasectomy. In an exemplary method, performing the vasectomymay comprise pinching the vas deferens with fingers, clamping the vasdeferens at two different points using any embodiment of the surgicalforceps disclosed above, and occluding the vas deferens. This exemplarymethod may further comprise flipping the surgical forceps prior tooccluding the vas deferens. The angled forceps may be more suitable forthe flipping action.

The previous description of the disclosed embodiments is provided toenable any person skilled in the art to make or use the surgicalforceps. Various modifications to these embodiments will be readilyapparent to those skilled in the art, and the generic principles definedherein may be applied to other embodiments without departing from thespirit or scope of the surgical forceps. Thus, the surgical forceps andmethods of performing vasectomy are not intended to be limited to theembodiments shown herein but are to be accorded the widest scopeconsistent with the principles and novel features disclosed herein.

We claim:
 1. A surgical forceps having a proximal end and a distal endcomprising: a first elongated arm and a second elongated arm; a hinge,wherein the first elongated arm and the second elongated arm are pivotedat the hinge; a first finger grip at the proximal end of the firstelongated arm; a second finger grip at the proximal end of the secondelongated arm; a ratcheting mechanism comprising a first ratchet on thefirst elongated arm adjacent to the first finger grip and a secondratchet on the second elongated arm adjacent to the second finger grip,wherein the first ratchet engages with the second ratchet as the fingergrips are brought toward one another; a first jaw at a distal end of thefirst elongated arm, wherein the first jaw is bifurcated to form a firstbranch and a second branch; and wherein the first branch furthercomprises a first tip at the distal end of the surgical forceps, andwherein the second branch further comprises a second tip at the distalend of the surgical forceps; a second jaw at a distal end of the secondelongated arm, wherein the second jaw is bifurcated to form a thirdbranch and a fourth branch; and wherein the third branch furthercomprises a third tip at the distal end of the surgical forceps, andwherein the fourth branch further comprises a fourth tip at the distalend of the surgical forceps; and wherein, when the ratchets are engaged,the first tip and the third tip form a first curved enclosure, and thesecond tip and the fourth tip form a second curved enclosure.
 2. Thesurgical forceps of the claim 1, wherein, when the ratchets are engaged;the first jaw and the second jaw form a first plane; and the firstfinger grip, the second finger grip, the first elongated arm, and thesecond elongated arm form a second plane; wherein the first plane andthe second plane are perpendicular to each other.
 3. The surgicalforceps of the claim 1, wherein, when the ratchets are engaged; thefirst jaw and the second jaw form a first plane; and the first fingergrip, the second finger grip, the first elongated arm, and the secondelongated arm form a second plane; wherein the first plane and thesecond plane are at an oblique angle to each other.
 4. The surgicalforceps of the claim 1, wherein the first elongated arm, the secondelongated arm, the hinge, or combinations thereof are bent at an angle.5. The surgical forceps of the claim 4, wherein the first elongated armand the second elongated arm are both bent at an angle.
 6. The surgicalforceps of the claim 4, wherein the hinge is bent at an angle.
 7. Thesurgical forceps of the claim 1, wherein the surgical forceps furthercomprises a stem located between the hinge and the distal end of thesurgical forceps; and wherein the stem has a broad base.
 8. The surgicalforceps of the claim 1, wherein the distance between the two branches ofthe first jaw and the distance between the two branches of the secondjaw are equal.
 9. The surgical forceps of the claim 8, wherein saidequal distance is at least 10 millimeters.
 10. The surgical forceps ofthe claim 9, wherein said equal distance varies within the range of 10millimeters to 30 millimeters.
 11. The surgical forceps of the claim 1,wherein the first curved enclosure and the second curved enclosure arecircular.
 12. The surgical forceps of the claim 11, wherein the firstcurved enclosure and the second curved enclosure have the same diameter,wherein the said diameter is at least 3 millimeters.
 13. The surgicalforceps of the claim 11, wherein the first curved enclosure and thesecond curved enclosure have the equal diameter, wherein the saiddiameter varies in the range of 3 millimeters to 5 millimeters.
 14. Thesurgical forceps of the claim 1, wherein the tips are configured toapply at least one surgical clip.
 15. A method for performing avasectomy comprising: pinching the vas deferens with fingers, clampingthe vas deferens with the surgical forceps of claim 1 at two locations,and occluding the vas deferens.
 16. A method for performing a vasectomycomprising: pinching the vas deferens with fingers, clamping the vasdeferens with the surgical forceps of claim 4 at two locations,separating the vas deferens from the surrounding tissue, and flippingthe surgical forceps prior to occluding the vas deferens.